Individual
CHALISE PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
14208038-4003
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14208038-4003
LICENSE
UT
Enumeration date
03/21/2025
Last updated
03/21/2025
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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